Medical Robotics - uniroma1.itvenditt/didattica/mr/09_daVinci.pdf · Vendittelli: Medical Robotics - da Vinci® surgical system 14 master console •the serial manipulators operated

Medical RoboticsMarilena Vendittelli

da Vinci® surgical system

sources for this lecture‣ http://www.intuitivesurgical.com/products/‣ http://investor.intuitivesurgical.com/phoenix.zhtml?c=122359&p=irol-IRHome‣ http://www.iwmr.polimi.it (presentation by Mike Yramategui)

http://www.intuitivesurgical.com/products/

http://www.intuitivesurgical.com/products/

http://investor.intuitivesurgical.com/phoenix.zhtml?c=122359&p=irol-IRHome

http://investor.intuitivesurgical.com/phoenix.zhtml?c=122359&p=irol-IRHome

http://www.iwmr.polimi.it

http://www.iwmr.polimi.it

Vendittelli: Medical Robotics - da Vinci® surgical system 2

difficulties of “manual” MIS


system overview

https://www.youtube.com/watch?v=VJ_3GJNz4fg




standard da Vinci® surgical system (introduced in 1999)


goal preserve the benefits to the patient of endoscopic surgery skills while giving back to the surgeon the dexterity of open surgery

• eye-hand coordination, stereoscopic vision (! depth)

• intuitive motion

• 7 dof at the tool tip

July 3, 2012 Overview of the da Vinci Surgical System

IEC – ISO JWG9 Workshop on Medical Robots

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da Vinci – Eliminates Laparoscopic Compromises



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produced by INTUITIVE SURGICAL http://www.intuitivesurgical.com/

• founded in 1995, public company in 2000

•headquarters in Sunnyvale, CA

•2500+ da Vinci systems worldwide

•2000+ employees

•~450.000 da Vinci procedures performed in 2012

•1.300.000+ in 1999-2011

•average cost ($ 1,0M - 2,3M) varies with instruments and accessories and service agreements

http://www.intuitivesurgical.com

http://www.intuitivesurgical.com


system installation through 2012


annual worldwide procedures

>500,000 in 2013

Vendittelli: Medical Robotics - da Vinci® surgical system 9© Di Maio, 2014




system overview



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da Vinci System Overview

Surgeon ConsolePatient Cart Vision Cart

Endoscopic Instruments


OR layout



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Typical OR Layout

Surgeon ConsoleVision Cart

Patient Cart

Patient


master console• the serial manipulators operated by the surgeon act as a high-resolution input device

• the images of the surgical site are sent to the surgeon through two independent vision channels

• the virtual image plane is positioned right above the hands

•switches and foot-actioned buttons allow the surgeon to control the position of the endoscope, to reposition the master and to adjust the camera focus



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System Overview – Surgeon Console

– Master Controllers

– Control Panels & Touchpad

High Resolution Stereo Viewer

Footswitch interface

Ergonomic Controls


3D vision system



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System Overview - Vision

Camera Head Touchscreen

Stereo Endoscope

Illuminator and Camera Electronics

Core Processor

• two optical channels with two independent 3-chip CCD

• two independent vision channels connected to two high-definition monitors with a frame rate of thousands of frames per second

• temperature at the endoscope extremity is automatically regulated

• image zooming, contrast improvement, noise reduction

• repositioning possible


slave robot



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System Overview - Patient Cart

Yaw

Pitch

Insertion

Roll

Yaw

Pitch

Patient Side Manipulator (PSM)

7 degrees of freedom

Grip

• three/four articulated arms mounted on a base•some joints are manually regulated at the beginning of the surgery and remain fixed during the surgery• the remaining joints are actuated and remotely controlled by the surgeon (plus filtering and motion scaling)• two/three arms hold the surgical tools while the third/fourth holds the endoscope•standard sterilization procedures of the surgical tools are allowed


Endo Wrist® tools

•about 40 different types of forceps, needle drivers, scalpel, scissors, cautery instruments,. . . (5 mm, 8 mm)•enhanced dexterity, precision and control•7 degrees of freedom, 90° degrees of articulation• intuitive motion and finger-tip control•ease of use: after an instrument is mounted to the da Vinci System, the interface recognizes the type and function of the instrument, and displays the number of uses


safety• redundant sensors, hardware watchdogs, real-time fault detection• transition to “safe state” before hazardous motion• system can be easily removed from patient in fault condition

• no autonomous motion of instruments

• instrument motion is under surgeon view and control



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• Multiple actions required for instruments to “follow”

– Sensor in viewer confirms surgeon’s head is in position

– Surgeon must “match” grip position before control

Key Safety Considerations



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• Multiple actions required for instruments to “follow”

– Sensor in viewer confirms surgeon’s head is in position

– Surgeon must “match” grip position before control



mechanical RCM



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• System incorporates remote center design

– Minimizes forces on the body wall

• Movements outside the body are relatively slow and

predictable

– Assistant can anticipate and avoid contact


•slow motion outside the body ) assistant can anticipate and avoid contact


da Vinci single-site

Robotic Surgery through a single umbilical port

• US FDA Cholecystectomy Clearance Dec 2011

• benign hysterectomy / Salpingo Oophorectomy 510K filed Q3 12

• 450+ US hospitals have purchased Single-Site products through Q4 12



still, costs are such thatmanual laparoscopy < robotic < open surgery

Documents

Medical Robotics - uniroma1.itvenditt/didattica/mr/09_daVinci.pdf · Vendittelli: Medical Robotics - da Vinci® surgical system 14 master console •the serial manipulators operated